CARLY LUCILLE KRIEDBERG DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****64

License Status

NOT RENEWED

Business

Title

DPM

First Name

CARLY

Middle

LUCILLE

Last Name

KRIEDBERG

Business Name

CARLY LUCILLE KRIEDBERG DPM

Original Issue Date

03/07/2016

Effective Date

01/06/2017

Expiration Date

01/31/2019

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/28/2019